I have pointed out in previous posts that Obama Care would in fact increase if not double the number of uninsureds with employers and individuals opting to pay a fine rather than insurance premiums. It's early, but I have already noticed a small reduction in my client base with more and more employers testing the waters of doing without health benefits. High unemployment is not helping matters as employers are finding that it is not necessary to provide benefits to attract employees.

Henry V

07-19-2010, 03:16 PM

I have pointed out in previous posts that Obama Care would in fact increase if not double the number of uninsureds with employers and individuals opting to pay a fine rather than insurance premiums. It's early, but I have already noticed a small reduction in my client base with more and more employers testing the waters of doing without health benefits. High unemployment is not helping matters as employers are finding that it is not necessary to provide benefits to attract employees.
Since the number of uninsured adults (18-64) in this country has been increasing since at least 1997 (CDC data and others), what evidence do you have that the small reduction in your client base can be attributed to the health care bill (which does not have a public option) rather than a continuation of the existing trend?

M&K's Retrievers

07-19-2010, 03:51 PM

Since the number of uninsured adults (18-64) in this country has been increasing since at least 1997 (CDC data and others), what evidence do you have that the small reduction in your client base can be attributed to the health care bill (which does not have a public option) rather than a continuation of the existing trend?

Maybe if you could build a huge chart and then write about 6 paragraphs the progressives would ooooh and ahhhh about it!!:D

rk

M&K's Retrievers

07-19-2010, 04:02 PM

Maybe if you could build a huge chart and then write about 6 paragraphs the progressives would ooooh and ahhhh about it!!:D

rk

This time next year, I may have plenty of time.:(

Buzz

07-19-2010, 04:03 PM

Yup, it makes perfect sense.

There was no mandate to provide coverage and no penalty for not providing it, and they were willing to scrape up the necessary dough to offer the benefit.

Now a mandate with penalty comes along and they decide that is the perfect time to save money by paying the penalty.

This year no one at our company got a raise because the premiums went up about $4800/year per family. I wonder what kind of quotes your clients got during renewal period for this year? Business is down and premiums are up, but I can't imagine that would have anything to do with it.

Yes, a sample size of one is highly scientific, especially when the observation is entirely consistent with a documented long-term trend and the health care reforms reported to causing them to drop coverage do not start for another 3 or 4 years.

road kill

07-19-2010, 06:54 PM

Yes, a sample size of one is highly scientific, especially when the observation is entirely consistent with a documented long-term trend and the health care reforms reported to causing them to drop coverage do not start for another 3 or 4 years.

I want to make a comment on human nature.

There were people who thought Obama would take care of all their bills.
We all heard it.

Those same people could very likely feel that insurance is free now, so why pay?

I don't have a graph to support this, just my experiences with people over the years.

Too bad what's happening.

rk

Franco

07-19-2010, 07:18 PM

Yup, it makes perfect sense.

There was no mandate to provide coverage and no penalty for not providing it, and they were willing to scrape up the necessary dough to offer the benefit.

Now a mandate with penalty comes along and they decide that is the perfect time to save money by paying the penalty.

This year no one at our company got a raise because the premiums went up about $4800/year per family. I wonder what kind of quotes your clients got during renewal period for this year? Business is down and premiums are up, but I can't imagine that would have anything to do with it.

I remember a thread back before Obamacare was passed in which I stated that employers would opt to pay the penalty rather than to continue paying a portion for thier employee's health insurance premiums.

Your statement was that there was no reason for an employer to stop offering the perk.

My opinion was that if employees had an option to go with gooberment insurance that many employers would stop offering this perk.

Last month, one of the larger national broadcast groups annouced that they would no longer contribute nor offer to thier employees health insurance after 7/31/11. I expect many companies to follow suit.

Obamacare will not last as we in this country are too accustomed to quality healthcare. When people realize how bad this new legislation is, the damage to the Democratic Party will be as bad as the damage done to the GOP by Bush43.

YardleyLabs

07-19-2010, 07:35 PM

I remember a thread back before Obamacare was passed in which I stated that employers would opt to pay the penalty rather than to continue paying a portion for thier employee's health insurance premiums.

Your statement was that there was no reason for an employer to stop offering the perk.

My opinion was that if employees had an option to go with gooberment insurance that many employers would stop offering this perk.

Last month, one of the larger national broadcast groups annouced that they would no longer contribute nor offer to thier employees health insurance after 7/31/11. I expect many companies to follow suit.

Obamacare will not last as we in this country are too accustomed to quality healthcare. When people realize how bad this new legislation is, the damage to the Democratic Party will be as bad as the damage done to the GOP by Bush43.
There is no option to go with a government program now any more than there was last year. If you are looking for explanations for dropped coverage look at the business economy and the size of premium increases. I terminated health insurance in my company because we could not pay the premiums unless we cut salaries. We passed the costs of the premium increases on to our employees and all but two dropped their coverage, joining the ranks of the uninsured.

Firms cancel health coverage
With cost rising, small companies turning to state

By Kay Lazar
Globe Staff / July 18, 2010

The relentlessly rising cost of health insurance is prompting some small Massachusetts companies to drop coverage for their workers and encourage them to sign up for state-subsidized care instead, a trend that, some analysts say, could eventually weigh heavily on the state’s already-stressed budget.

Since April 1, the date many insurance contracts are renewed for small businesses, the owners of about 90 small companies terminated their insurance plans with Braintree-based broker Jeff Rich and indicated in a follow-up survey that they were relying on publicly-funded insurance for their employees.

Firms cancel health coverage
With cost rising, small companies turning to state

By Kay Lazar
Globe Staff / July 18, 2010

The relentlessly rising cost of health insurance is prompting some small Massachusetts companies to drop coverage for their workers and encourage them to sign up for state-subsidized care instead, a trend that, some analysts say, could eventually weigh heavily on the state’s already-stressed budget.

Since April 1, the date many insurance contracts are renewed for small businesses, the owners of about 90 small companies terminated their insurance plans with Braintree-based broker Jeff Rich and indicated in a follow-up survey that they were relying on publicly-funded insurance for their employees.

-more-
That is actually an excellent example, Eric, of what I hope happens. Public plans offer lower costs of coverage than are available to small businesses. It also gives employees a guaranteed vehicle for purchasing coverage that is not provided by an employer. I would have been happy at any time to add the amount I contributed to health insurance premiums to my employees' paychecks so that they could buy their own insurance. Having done that, I would have been more willing to hire new staff without the fear that the next hire would bankrupt e in benefit costs. One employee worked for me three weeks before having open heart surgery that cost me more than $150,000. I even had to refund the small payments I had received from a client for his services and provide a replacement consultant with the first six weeks free to compensate my client for time lost on their project because of his heart attack.If national coverage accelerates the end of employer paid insurance, our economy will benefit dramatically.

Franco

07-19-2010, 08:12 PM

That is actually an excellent example, Eric, of what I hope happens. Public plans offer lower costs of coverage than are available to small businesses. It also gives employees a guaranteed vehicle for purchasing coverage that is not provided by an employer. I would have been happy at any time to add the amount I contributed to health insurance premiums to my employees' paychecks so that they could buy their own insurance. Having done that, I would have been more willing to hire new staff without the fear that the next hire would bankrupt e in benefit costs. One employee worked for me three weeks before having open heart surgery that cost me more than $150,000. I even had to refund the small payments I had received from a client for his services and provide a replacement consultant with the first six weeks free to compensate my client for time lost on their project because of his heart attack.If national coverage accelerates the end of employer paid insurance, our economy will benefit dramatically.

Why were you on the hook for his medical expenses? If you provided health insurance, that cost would be covered. If he was not employed long enough to have insurance with your company than he is responsible for payment.

YardleyLabs

07-19-2010, 08:20 PM

Why were you on the hook for his medical expenses? If you provided health insurance, that cost would be covered. If he was not employed long enough to have insurance with your company than he is responsible for payment.
It was an experience rated plan. We had to cover the value of excess payments made. That, combined with one employee receiving fertility treatments and then having a complicated pregnancy resulted in 40%+ premium increases in each of the following three years.

Franco

07-19-2010, 08:33 PM

I had a co-worker that had open-heart surgery two years ago and his out-of-pocket was less than $3,000. That's a huge difference from your $150,000.00 out-of-pocket!

YardleyLabs

07-19-2010, 08:41 PM

I had a co-worker that had open-heart surgery two years ago and his out-of-pocket was less than $3,000. That's a huge difference from your $150,000.00 out-of-pocket!
My employee had about the same out of pocket. The $150,000 was out of my pocket. The privilege of ownership.:rolleyes:

That is actually an excellent example, Eric, of what I hope happens. Public plans offer lower costs of coverage than are available to small businesses.Where are these magical plans? It also gives employees a guaranteed vehicle for purchasing coverage that is not provided by an employer. I would have been happy at any time to add the amount I contributed to health insurance premiums to my employees' paychecks so that they could buy their own insurance. Having done that, I would have been more willing to hire new staff without the fear that the next hire would bankrupt e in benefit costs. One employee worked for me three weeks before having open heart surgery that cost me more than $150,000. 1. He should have still been in the waiting period and not on your plan yet. 2. You shouldn't have any liability and 3. where can you get open heart surgery for $150,000? I even had to refund the small payments I had received from a client for his services and provide a replacement consultant with the first six weeks free to compensate my client for time lost on their project because of his heart attack.If national coverage accelerates the end of employer paid insurance, our economy will benefit dramatically.

This doesn't sound right.

M&K's Retrievers

07-19-2010, 09:03 PM

That is actually an excellent example, Eric, of what I hope happens. Public plans offer lower costs of coverage than are available to small businesses. It also gives employees a guaranteed vehicle for purchasing coverage that is not provided by an employer. I would have been happy at any time to add the amount I contributed to health insurance premiums to my employees' paychecks so that they could buy their own insurance. Having done that, I would have been more willing to hire new staff without the fear that the next hire would bankrupt e in benefit costs. One employee worked for me three weeks before having open heart surgery that cost me more than $150,000. I even had to refund the small payments I had received from a client for his services and provide a replacement consultant with the first six weeks free to compensate my client for time lost on their project because of his heart attack.If national coverage accelerates the end of employer paid insurance, our economy will benefit dramatically.

It was an experience rated plan. We had to cover the value of excess payments made. That, combined with one employee receiving fertility treatments and then having a complicated pregnancy resulted in 40%+ premium increases in each of the following three years.

Jeff, how big was your group? I've been doing this for 35+ years and have never heard of this before even with self funded cases.

YardleyLabs

07-19-2010, 09:22 PM

Jeff, how big was your group? I've been doing this for 35+ years and have never heard of this before even with self funded cases.
110 covered employees.

Franco

07-19-2010, 09:56 PM

Jeff, how big was your group? I've been doing this for 35+ years and have never heard of this before even with self funded cases.

I've never heard of such a thing myself. You either have insurance or you don't.

All I know is that insurace companies are increasing thier fees in responce to Obamacare.

M&K's Retrievers

07-19-2010, 10:37 PM

That is actually an excellent example, Eric, of what I hope happens. Public plans offer lower costs of coverage than are available to small businesses. It also gives employees a guaranteed vehicle for purchasing coverage that is not provided by an employer. I would have been happy at any time to add the amount I contributed to health insurance premiums to my employees' paychecks so that they could buy their own insurance. Having done that, I would have been more willing to hire new staff without the fear that the next hire would bankrupt e in benefit costs. One employee worked for me three weeks before having open heart surgery that cost me more than $150,000. I even had to refund the small payments I had received from a client for his services and provide a replacement consultant with the first six weeks free to compensate my client for time lost on their project because of his heart attack.If national coverage accelerates the end of employer paid insurance, our economy will benefit dramatically.

Sounds like an employer committed something to a new employee without clearing it with the insurance company and had to eat the claim or be sued by said employee. Why would a new employee be covered after 3 weeks employment? No pre-employment physical? What did the State Insurance Department, your attorney and your agent have to say when you complained?

Just wondering regards,

Gerry Clinchy

07-19-2010, 10:42 PM

It was an experience rated plan. We had to cover the value of excess payments made. That, combined with one employee receiving fertility treatments and then having a complicated pregnancy resulted in 40%+ premium increases in each of the following three years.

I'm just guessing, but if the plans for these people were through "exchange" plans, these additional expenses would ultimately fall to the taxpayers (through higher premiums for the plans offered through the "exchanges")

In the discussions leading up to passing the health reform bill, there was never any real talk about price of the coverages. Somewhere along the way, it was very quietly mentioned that we should expect to pay more for coverage in order to encompass the pre-existing conditions (had always been a logical premise to me) ... but I think that there will be some eye-popping when we actually get our bills for premiums.

Henry V

07-19-2010, 10:43 PM

.....

All I know is that insurace companies are increasing thier fees in responce to Obamacare.
Health insurance rates doubled in the last ten years and now the increases are because of a federal health care bill which has yet to mostly take effect. Bull. This is just a convenient excuse for companies to continue the trend.

Gerry Clinchy

07-19-2010, 10:45 PM

Sounds like an employer committed something to a new employee without clearing it with the insurance company and had to eat the claim or be sued by said employee. Why would a new employee be covered after 3 weeks employment? No pre-employment physical? What did the State Insurance Department, your attorney and your agent have to say when you complained?

Just wondering regards,

M&K, I haven't been in the life/health insurance business in many years, but when I was, it was very common for employers to require a period of employment anywhere from 30 to 90 days before an employee was eligible for employer-paid health insurance. Is this still allowed?

M&K's Retrievers

07-20-2010, 12:21 AM

M&K, I haven't been in the life/health insurance business in many years, but when I was, it was very common for employers to require a period of employment anywhere from 30 to 90 days before an employee was eligible for employer-paid health insurance. Is this still allowed?

Yes. It varies by state but usually no more than 90 days for a conventionally insured program. A self-insured plan protected by specific and aggregate stop loss insurance may be able to have a different waiting period determined by the plan document.

Gerry Clinchy

07-20-2010, 12:46 AM

Yes. It varies by state but usually no more than 90 days for a conventionally insured program. A self-insured plan protected by specific and aggregate stop loss insurance may be able to have a different waiting period determined by the plan document.

Such a waiting period could have helped Jeff on his health insurance. However, he still would have been on the hook with his client for the time lost when time was lost on the client's project.

M&K's Retrievers

07-20-2010, 01:07 AM

Such a waiting period could have helped Jeff on his health insurance. However, he still would have been on the hook with his client for the time lost when time was lost on the client's project.

Something is odd about this deal but I'll leave that alone. As far as his commitment to his client, what has that to do with his insurance program.

Gerry Clinchy

07-20-2010, 07:56 AM

Something is odd about this deal but I'll leave that alone. As far as his commitment to his client, what has that to do with his insurance program.

It sounds like Jeff's plan involved some self-insurance. I'd say the agent was remiss in not suggesting a waiting period for new hires. Also seems somewhat unusual for someone who needed open heart surgery not to have had any prior knowledge of a heart problem? Perhaps the very reason he chose Jeff's firm for employment?

I was also of the impression that most plans did not include coverage for fertility treatments ... although they would still cover the complications of the pregnancy.

Nope, there is no connection to health insurance WRT Jeff's costs related to the project costs of the ill employee. I don't think Jeff is the person I will ask to buy me a lottery ticket :-)

YardleyLabs

07-20-2010, 10:13 AM

This doesn't sound right.We had no waiting period for joining the plan. That was a selling point in hiring staff. The fertility treatment option was a left over from the company that I had purchased. The former owner was Catholic and very active in the right to life movement. The plan specifically prohibited coverage for abortion and specifically authorized payment for fertility treatments. We were self insured. The plan provisions were relatively luxurious. The former owner had restricted coverage to persons that were salaried and did not cover hourly employees regardless of the fact that they worked full time and had been with the company for a long time. I extended coverage to all employees when I purchased the company to avoid violating the law, but did not otherwise review coverage. Following this incident, I eliminated coverage for fertility treatments, instituted coverage for abortions (making our plan consistent with New Jersey norms), and purchased insurance for claims over $25,000. Ultimately I converted the entire plan to an insured plan. The payments made to the client were partly a product of my contract with them and partly a cost of good will. The had nothing to do with the health insurance program.

Buzz

07-20-2010, 10:21 AM

..........................

http://www.kaiserhealthnews.org/Columns/2010/July/071910Cohn.aspx

When Bad News About Health Reform Isn't Bad
Print Share Email

TOPICS: HEALTH REFORM

Jonathan Cohn, Senior Editor of The New Republic
JUL 19, 2010

The weekend’s newspapers included a pair of headlines about health care reform. And they were probably not the kind that reform advocates like to see.

One was in the Boston Globe: “Firms Cancel Health Coverage.” According to the article, a number of small businesses had recently decided to stop offering insurance to employees. In 2006, Massachusetts put in place a new health insurance scheme similar to the Patient Protection and Affordable Care Act, the federal law President Barack Obama and congressional Democrats passed earlier this year. If businesses in Massachusetts were now dropping coverage three years into that state’s reform experiment, people might conclude the same will happen across the country. And they probably wouldn’t like that very much.

The other headline was in Sunday’s New York Times: “Insurers Push Plans Limiting Patient Choice of Doctors.” As the story explained, insurers in three cities (Chicago, New York and San Diego) were testing new plans that offered beneficiaries significantly reduced networks of doctors and hospitals, in exchange for lower premiums. The target audience, again, was small businesses, but the insurers thought the new plans might appeal to some larger businesses as well.

This isn’t the first time insurers have offered plans with fewer treatment options. It happened most famously in the 1990s, when insurers first introduced the concept of “managed care” on a wide scale. Consumers didn’t like it then, and they might not like it now. But last time, most people blamed the insurance industry. This time, they might blame the government--in no small part because reform critics will use the occasion to say, “I told you so.”

Taking the blame for anything and everything that goes wrong in health care has always been the biggest political danger to reform, at least in the short term. The Obama administration and the Democrats now “own” health care just as surely as they own General Motors. But before Sean Hannity or the Wall Street Journal editorial page get their hands on these stories, let’s be clear about something: Those headlines don't highlight reform’s problems. They actually highlight its virtues.

Insofar as the articles report broader trends--and they may not--they actually chronicle the same basic process at work. Health care is getting more expensive; the economy is still sputtering. Employers who provide and help pay for employee coverage can react to this in one of two ways. They can stop offering insurance altogether, which is what the Globe reports some small Massachusetts firms are doing. Or they can simply offer less generous policies, which is what the Times suggest will happen in those three cities.

But employers were doing these things already, long before Obama and his allies came along. Firms have been walking away from coverage ever since the early 1970s, when rising health care costs first hit American business hard. The question is whether reform makes employers more likely to drop coverage. The answer seems to be no, at least for now. Reform includes a requirement that employers provide insurance or pay a penalty. Although the Globe story suggests a few firms are dropping coverage, the official data shows that, overall, the number of employers offering coverage actually increased after Massachusetts implemented its new scheme.

That doesn’t mean every company that offers insurance will keep doing it forever. Over time, some businesses will inevitably decide to drop coverage, just as they do now. But before reform, employees in such companies were frequently in big trouble, since they no longer had access to decent policies they can afford. In Massachusetts and, soon, the rest of the country, people without employer coverage will be able to get comprehensive policies through insurance exchanges--complete with subsidies to help pay for them.

But what about the people who watch as employers whittle down coverage, restricting which doctors and hospitals they can see? Again, this happened before and was bound to happen again--only now, thanks to health reform, the law will limit how plans can do it. They can’t impose cost-sharing for basic preventive care. They can’t impose annual or lifetime dollar caps on benefits. And while they can limit beneficiaries to certain doctors and hospitals, they have to offer beneficiaries the right to appeal treatment denials--and the right to get treatment out-of-network if it’s not available in-network.

These guarantees aren’t as strong as they could or should be. Future legislators, hopefully, will improve upon them. But they provide real security, the kind that didn’t exist before--and the kind that most Americans should appreciate, even if the critics of reform don’t.

M&K's Retrievers

07-20-2010, 10:56 AM

We had no waiting period for joining the plan. That was a selling point in hiring staff. The fertility treatment option was a left over from the company that I had purchased. The former owner was Catholic and very active in the right to life movement. The plan specifically prohibited coverage for abortion and specifically authorized payment for fertility treatments. We were self insured. The plan provisions were relatively luxurious. The former owner had restricted coverage to persons that were salaried and did not cover hourly employees regardless of the fact that they worked full time and had been with the company for a long time. I extended coverage to all employees when I purchased the company to avoid violating the law, but did not otherwise review coverage. Following this incident, I eliminated coverage for fertility treatments, instituted coverage for abortions (making our plan consistent with New Jersey norms), and purchased insurance for claims over $25,000. Ultimately I converted the entire plan to an insured plan. The payments made to the client were partly a product of my contract with them and partly a cost of good will. The had nothing to do with the health insurance program.

Let's be clear that "self insured" merely refers to how claims are funded. Typically, in return for much lower premiums, the employer self funds claims up to a specific amount in Jeff's case $25,000. Claims in excess of this amount are paid by the specific stop loss carrier. To protect the employer from a catastrophic year, aggregate stop loss coverage is also purchased which usually kicks in when the self funded claims exceed 125% of expected claims for the year. If all goes as expected, the cost for the stop loss coverages, claims paid and administrative fees will be considerably less than a conventionally insured program. If they have a bad year, the employer may in actually pay more than conventional coverage. The advantages of self funding in addition to premium savings are more flexible plan design (in this case excluding hourly employees, no waiting period for new hires, fertility, etc), avoidance of some state and federal mandates, less premium tax, etc.

Boring insurance 101 regards,

Gerry Clinchy

07-21-2010, 06:11 AM

We had no waiting period for joining the plan. That was a selling point in hiring staff.